• Title/Summary/Keyword: 중재방법

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2020 Dietary Reference Intakes for Koreans: riboflavin (2020 한국인 영양소 섭취기준: 리보플라빈)

  • Lee, Jung Eun;Cho, Jin Ah;Kim, Ki Nam
    • Journal of Nutrition and Health
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    • v.55 no.3
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    • pp.321-329
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    • 2022
  • Riboflavin and its derivatives, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), are key components of mitochondrial energy metabolism and oxidation-reduction reactions. Proposed dietary reference intakes for Koreans (KDRIs), that is, estimated average requirements (EARs), for riboflavin, based on current knowledge of riboflavin and riboflavin derivative levels, and glutathione reductase activity, are 1.3 mg/d for men aged 19-64 years and 1.0 mg/d for women aged 19-64 years. By applying a coefficient of variance of 10%, reference nutrient intakes (RNIs) were set at 1.5 mg/d for men aged 19-64 years and 1.2 mg/d for women aged 19-64 years. Likewise, EARs and RNIs of riboflavin intake were proposed for all age groups and women in specific life stages such as pregnancy. Mean adult riboflavin intake for adults aged ≥ 19 years was 1.69 mg/d in Korea National Health and Nutrition Examination Survey (KNHANES) 2020, which was 124.9% of EAR according to the 2020 KDRIs. In the 2015-2017 KNHANES study, the mean riboflavin intake from foods and supplements was 2.79 mg/d for all age groups, and 32.7% of individuals consumed less riboflavin than EAR according to the 2020 KDRIs. For those that used supplements, mean intakes were 1.50 mg/d for riboflavin from foods, 10.26 mg/d from supplements, and 11.76 mg/d from food and supplements, and 5.5% of individuals consumed less riboflavin than EAR. Although the upper limit of riboflavin has not been established, the merits of increasing supplement use warrant further consideration. Also, additional epidemiologic and intervention studies are required to explore the role of riboflavin in the etiology of chronic diseases.

Efficacy of Preliminary Magnetic Resonance Imaging Measurement in Ultrasonography-Guided L4 Selective Nerve Root Block (초음파 유도하 요추 4번 선택적 신경근 차단술 시 자기공명영상 계측의 유용성)

  • Shim, Dae Moo;Kweon, Seok Hyun;Cho, Hyung Gyu;Yu, Hyun Kyu;Lim, Kyeong Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.229-236
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    • 2020
  • Purpose: This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. Materials and Methods: As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. Results: At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). Conclusion: A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure.

Impact of Gender Differences in Elderly Patients with Acute Myocardial Infarction (고령의 급성 심근경색증 환자에서 성별에 따른 영향)

  • Seol, Soo Young;Jeong, Myung Ho;Lee, Seung Hun;Sohn, Seok-Joon;Cho, Jae Yeong;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Park, Hyung Wook;Kim, Ju Han;Ahn, Youngkeun;Cho, Jeong Gwan;Park, Jong Chun
    • The Korean Journal of Medicine
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    • v.94 no.1
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    • pp.96-106
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    • 2019
  • Background/Aims: It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI. Methods: We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients (≥ 75 years) diagnosed with AMI. Results: A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 ± 4.4 vs. 79.6 ± 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001). Conclusions: No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up.

The effect of restrictions on oral health-related activities of adults in Korea on quality of life: Using the 8th Korean National Health and Nutrition Examination Survey (우리나라 성인의 구강건강 관련 활동 제한이 삶의 질에 미치는 영향: 국민건강영양조사 제8기 1차년도(2019)자료 활용)

  • Mi-Jeong Kim;Cha-Young Lim
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.173-182
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    • 2023
  • Background: This study aims to investigate the effect of restrictions on oral health-related activities of young adults, middle-aged, and elderly in Korea on the quality of life and contribute to the development of intervention strategies to improve the quality of life by improving the importance of oral health care and healthy lifestyle habits of adults. Methods: The 8th National Health and Nutrition Survey was used, targeting adults categorized into three age groups: young adults aged 19 to 29, middle-aged adults aged 30 to 49, and prime-aged adults aged 50 to 64. Demographic characteristics and EQ-5D, HINT-8 and oral-related toothache experience, chewing problems, speaking problems, and complaint of discomfort to chew analyzed. T-test and one-way ANOVA were performed to find out the difference in quality of life according to the restrictions on oral activities of adults, and linear regression analysis was performed to investigate the factors affecting the quality of life of adults. Results: The differences between EQ-5D and HINT-8 according to the restrictions on oral health-related activities of young, middle-aged, and prime-aged were statistically significant in all oral activity restriction variables(p ≦0.05). Factors affecting EQ-5D of all adults were statistically significant in all variables such as region, gender, household monthly income, education level, basic living status, economic activity, subjective oral health status, toothache experience, chewing problem, speaking problem, and complaint of discomfort to chew(p ≦0.05). Factors affecting HINT-8 of all adults were statistically significant in variables such as gender, household monthly income, education level, basic living status, economic activity, toothache experience, chewing, speaking, and complaint of discomfort to chew(p ≦0.05). Conclusions: Various measures are needed to improve the quality of life in old age by allowing adults to face physically, mentally, and socially prepared old age. Based on the results of this study, an adult oral health program should be developed to improve the oral health and quality of life of adults.

Changes in Mental Health Status of Patients in the Community Treatment Center during the Quarantine Period (생활치료센터 환자의 격리 치료 기간 중 정신건강 상태 변화)

  • Jeong-Wook Seo;Jeonga Yoo;Jin-Yong Jun;Jiho Lee
    • Health Policy and Management
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    • v.34 no.3
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    • pp.293-308
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    • 2024
  • Background: Assessing the change in mental health status of quarantined patients in community treatment centers at the time of admission and discharge, and inferring the influencing factors. Methods: The study was conducted on a sample of 1,941 quarantined patients from three community treatment centers. Changes in anxiety, psychological distress, post-traumatic stress, depression, and self-harm ideation between admission and discharge were categorized as either "improved" or "worsened." Inference was performed to determine the probability of worsening in mental health status. Results: The mental health status of quarantined patients, such as anxiety and depression, was relatively higher than that of the general population. Anxiety (84.3% improved) and psychological distress (79.0% improved) were reduced during quarantine treatment. However, some patients continued to experience moderate to severe levels of anxiety (11.2%) and psychological distress (11.0%) at discharge. As for depression, the depression of moderate or higher level was increased at the time of discharge (28.7%→36.7%) compared to admission. The deterioration of anxiety and psychological distress was found to be the most significant factor influencing the worsening of depression at discharge (odds ratio [OR] for anxiety deterioration, 2.04; OR for psychological distress deterioration, 3.56). These effects were also observed similarly in post-traumatic stress and self-injury ideation. Conclusion: Improving anxiety and psychological distress among quarantined patients in community treatment centers can reduce the worsening of post-traumatic stress, depression, and self-injury ideation at the time of discharge. These findings provide evidence for the need for active mental health management from the initial stages of quarantine treatment.

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients (고도비만환자에서 베리아트릭 수술 (Bariatric Surgery) 후 영양교육이 체중감량에 미치는 효과)

  • Jeong, Eun-Ha;Lee, Hong-Chan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.30-45
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    • 2015
  • Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

Mid-Term Results of 292 cases of Coronary Artery Bypass Grafting (관상동맥 우회술 292례의 중기 성적)

  • 김태윤;김응중;이원용;지현근;신윤철;김건일
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.643-652
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    • 2002
  • As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF<40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

Off-pump Coronary Artery Bypass Surgery Versus Drug Eluting Stent for Multi-vessel Coronary Artery Disease (다혈관 관상동맥질환에서의 심폐바이패스를 사용하지 않은 관상동맥우회술과 약물용출 스텐트시술)

  • Lee, Jae-Hang;Kim, Ki-Bong;Cho, Kwang-Ree;Park, Jin-Shik;Kang, Hyun-Jae;Koo, Bon-Kwon;Kim, Hyo-Soo;Sohn, Dae-Won;Oh, Byung-Hee;Park, Young-Bae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.202-209
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    • 2008
  • Background: The introduction of Drug Eluting Stents (DES) decreased the number of patients referred for coronary artery bypass grafting (CABG). The impact of DES on CABG (Step 1) was studied and compared with the 1-year outcome after CABG with DES (Step 2). Material and Method: Surgical results for patients who underwent off-pump CABG (OPCAB) before the introduction of DES(n=298) were compared with those who underwent OPCAB after the introduction of DES (n=288) (Step 1). Postoperative 30-day and 1-year results were also compared between the patients who underwent percutaneous coronary intervention (PCI) using DES (n=220) and those who underwent OPCAB (n=255) (Step 2). Result: Since the introduction of DES, the ratio of CABG versus PCI decreased. In the CABG group, the number of high risk patients such as elderly patients (age 62 vs. 64, p=0.023), those with chronic renal failure (4% vs. 9%, p=0.021), calcification of the ascending aorta (9% vs. 15%, p=0.043), or frequency of urgent or emergent operations (12% vs. 22%, p=0.002) increased. However, there were no differences in the cardiac death and graft patency rates between the two groups (step 1). During the one-year follow up period, the rate of target vessel revascularization (12.3% vs. 2.4%, p<0.001) and major adverse cardiac events (MACE: death, myocardial infarct, TVR) were higher in the DES than the CABG group (13.6% vs 4.3%) (stage 2). Conclusion: Introduction of DES decreased the number of patients referred for surgery, and increased the comorbidity in patients who underwent CABG. DES increased the rate of target vessel revascularization, and the occurrence of MACE during the 1-year follow-up. However, there was no difference in the incidence of myocardial infarction and cardiac death between the two groups.